Jan Louise Cooper, O.D., F.A.A.O.
Individual provider Active NPI Optometrist · Highland, CA
NPI 1235294935 · NPPES record last updated Jul 10, 2009
Key facts
- NPI
- 1235294935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8696T (CA)
- Practice address
- 3693 Highland Ave
Suite D
Highland, CA 92346-2609 - Phone
- (909) 425-2020
- Fax
- (909) 425-2237
- NPI assigned
- Dec 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8696T | CA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James Espinosa O.D. | Optometrist | Past |
Accepting new patients |
Interoperability endpoints
- jan.cooperod.p1@direct.jwch.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8696T | CA | Yes |
Addresses
Primary practice location
3693 Highland Ave
Suite D
Highland, CA 92346-2609
Mailing address
101 Chandler W
Highland, CA 92346-5482
Phone (909) 864-0987
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0086960 | Medicaid | CA | |
| 7053419 | Other | CA | MEDICAID PIN |
Other names
- Dr. Jan Louise Cooper Hagman
Other providers in Highland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.